Joel Ho1, Kora DeBeck2,3, M-J Milloy2,4, Huiru Dong2,5, Evan Wood2,4, Thomas Kerr2,4, Kanna Hayashi2,6. 1. a Department of Medicine , University of Manitoba, Health Sciences Centre , Winnipeg , Canada. 2. b British Columbia Centre on Substance Use , British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , Canada. 3. c School of Public Policy , Simon Fraser University , Vancouver , Canada. 4. d Department of Medicine , University of British Columbia, St. Paul's Hospital , Vancouver , Canada. 5. e School of Population and Public Health , University of British Columbia , Vancouver , Canada. 6. f Faculty of Health Sciences , Simon Fraser University , Burnaby , Canada.
Abstract
BACKGROUND: Nonmedical use of prescription opioid and illicit opioid has been increasing at an alarming rate in North America over the past decade. OBJECTIVE: We sought to examine the temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada. METHODS: Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone). We defined perceived availability as immediate (e.g., available within 10 minutes) versus no availability/available after 10 minutes. The trend and correlation of immediate availability were identified by multivariable generalized estimating equations logistic regression. RESULTS: Among 1584 participants, of which 564 (35.6%) were female, the immediate availability of all illicit and prescribed opioids (except for oxycontin/OxyNEO) increased over time, independent of potential confounders. The Adjusted Odds Ratios of immediate availability associated with every calendar year increase were between 1.09 (95% confidence interval 1.05-1.12) (morphine and Dilaudid) and 1.13 (95% confidence interval 1.09-1.17) (Percocet/Vicodin/Demerol) (all p-values <0.05). CONCLUSION: The availability of most prescription opioids had continued to increase in recent years among our sample of PWID in Vancouver. Concurrent increases in the availability of heroin were also observed, raising concerns regarding combination of both illicit and prescription opioid use among PWID that could potentially increase the risk of overdose.
BACKGROUND: Nonmedical use of prescription opioid and illicit opioid has been increasing at an alarming rate in North America over the past decade. OBJECTIVE: We sought to examine the temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada. METHODS: Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone). We defined perceived availability as immediate (e.g., available within 10 minutes) versus no availability/available after 10 minutes. The trend and correlation of immediate availability were identified by multivariable generalized estimating equations logistic regression. RESULTS: Among 1584 participants, of which 564 (35.6%) were female, the immediate availability of all illicit and prescribed opioids (except for oxycontin/OxyNEO) increased over time, independent of potential confounders. The Adjusted Odds Ratios of immediate availability associated with every calendar year increase were between 1.09 (95% confidence interval 1.05-1.12) (morphine and Dilaudid) and 1.13 (95% confidence interval 1.09-1.17) (Percocet/Vicodin/Demerol) (all p-values <0.05). CONCLUSION: The availability of most prescription opioids had continued to increase in recent years among our sample of PWID in Vancouver. Concurrent increases in the availability of heroin were also observed, raising concerns regarding combination of both illicit and prescription opioid use among PWID that could potentially increase the risk of overdose.
Authors: Tara Gomes; Muhammad M Mamdani; J Michael Paterson; Irfan A Dhalla; David N Juurlink Journal: Can Fam Physician Date: 2014-09 Impact factor: 3.275
Authors: Thomas Kerr; Nadia Fairbairn; Mark Tyndall; David Marsh; Kathy Li; Julio Montaner; Evan Wood Journal: Drug Alcohol Depend Date: 2006-09-07 Impact factor: 4.492
Authors: Evan Wood; Thomas Kerr; Brandon D L Marshall; Kathy Li; Ruth Zhang; Robert S Hogg; P Richard Harrigan; Julio S G Montaner Journal: BMJ Date: 2009-04-30